| Show I ASTEUR8 PUPIL 1 Dr Gibier Discusses the Treatment Treat-ment of Hydrophobia I OOG KILLING IS A BLUNDER flow to Act After Being BIttenCauterizatlon e Deprecated The Peculiarities of Patients Pa-tients A National Institute For THE SUNDAY HERALD Copyrighted j2 While in this country on a professional 01 r rS pro-fessional mission ttJt I 0 during a part of 1t the years 1SSS and sr tt 1SS9 my attention q Ja > = d 4 Ji i I was frequently t A 4 ia F attracted to publications t 4 pub-lications in the t 7 newspapers stating r r stat-ing that hydrophobia 1 iS4 lfi dd hydro-phobia had oc H jil cuired at certain JJ places and that d 21 the persons who were the victims bad bn bitten weeks before by animals not then known to be raoid The story was invai Ibly the same The < dog summarily summar-ily kiLea I the wound either roughly cauterized I cau-terized or neglected and the fatal sequel J1It was the frequency of these cases that first suggested to my mind the idea of establishing es-tablishing in this country an insittutc modeled mod-eled after that of my eld teacher the dis tinguisabd Pasteur in Paris Returning to France I passed several months there where I studied with IL Pasteur the question of establishing an institute 1 in-stitute America On December 1 ISSJ I J again came to America the institute project I pro-ject now fully matured in my mind My d iirst care was to take this house and strangely enough on the very day I was in stal I was prostrated by la grippe and was for fifteen days my own patient The institute furnished I next established a laboratory a task that occupied much time Us instruments I had long ago They arc of Pasteurs own invention and have been e used in the work a long time The chief delay was in the time consumed in makin the preparations for inoculation I found it necessary to spend two months in the preparation of the virus in its various cultures cul-tures and different degrees of strength In February the institute was formally opened Soon patients began to come in from New York city and Long Island At the beginning begin-ning of March one from Maryland came to be treated In all I have treated at this institute in-stitute fiftyone patients since its opening In addition to these I have inoculated five others none of whom have been bitten my two assistants my servants and myself This was purely a measure of precaution for there is serious danger of accidental inoculation in-oculation during the manipulation of the virus and it would be a very easy matter to contract hydrophobia while treating others A little scratch touched accidentally accident-ally by the virus would be sufficient The disciples of Pasteur should show their cOn iilence in the principles of the master by ipplying them to themselves The largest number of patients in the institute in-stitute at one time was twenty four I There are now twentytwo under treatment i treat-ment Thus far there have been no failures fail-ures and no deaths have occurred among those who have been treated But I am Avery differently situated from Pasteur in one respect The patients come here much later than those who go to the Pasteur institute in-stitute in Paris many of them arrive fifteen fif-teen or twenty days after having been bit lcD and I have one who came after thirty live days had elapsed Such cases I treat l > v a special methoda very strong one which 1 have iuaugurated according to the personal advice of M Pasteur with whom I consulted on the subject These late rises were a matter of serious considera jan and for such he was at the trouble to give me special instructions In the beginning of the treatment for ordinary or-dinary cases the virus is very weak haying hay-ing been made so by a method which it would bo tedious to explain The first Inoculation In-oculation could not give rabies even to a oung mouse But after two or three days the virus used increases in strength and it could then perhaps give hydrophobia to a 3 oung mouse Alter five days it could give labieb to a small rat but not to a big one A fortiori it would be impossible to give itt it-t a man Gradually the body becomes ac estcmedto the viius as the strength increases in-creases and when the last injection is given the virus is quite virulent Being injected in large quantity when weak it gradually reaches the nervous system the brain the medulla which are affected specially by bydropnobia As the nerves and brain become accustomed to the weak Mrus the latter is abandoned and the stronger quality used When this point has been reached the virus of a rabid dog is weaker than the virus I inject With tlC virus of a dog I GUI Kill in twenty or twentyfive days the virus I inject at the last stages of the treatmnt would kill with all the true yniptons of hydrophobia in ten or twelve days But the rervoas tystem having already become accustomed to the virus in its various degrees off of-f receives it harmlessly and is fortified for-tified by it against rabies jlSt as those who have been inoculated with cowpoxwhich souc scientists hold to be another form of smtlpor are enabled to resist the attacks 01 smallpox itself Ago manes no material difference in the treatment of patients Possibly the young take tho inoculation slightly hotter than adults do All tOe patients take the treat men well TLs is epeciullv true of tbti small ehilumi They cry a little at first as almost any child 11 ould when a probe is inserted into its body Then after a few experiences they seem to think lb i wasnt worth crying or after alL J always in 1 k e I i IXOCULATIXG WITh TIm VIRUs Dculate on the sides of tho body The process pro-cess Is exactly similar to injecting morphine mor-phine and it gives the same sensation j except that it does not put the patient to sleep 1 have had patients from many states I from Texas Missouri Maryland New l Hampshire New York and even from Can p Bda Many of them are poor patients < tor such cases when they come from disl j I T oJ L I tant points the cities usually pay but ere in New York the treatment is gratuitous gratui-tous No rule can be laid down for telling I whether adog has true hydrophobia or not i In the early stages A dog is dangerous live six or eight days befou he begins to i show the sMnptims ol rabies and even at thatstage he can communicate hydrophobia Cases have been known where experimentalists experiment-alists have inoculated some dogs with hy drophobia with the syringe or lancet and after two or three days their saliva has been tried with a view to determining its virulence Sometimes it was demonstrated that even before they began to show any evidences of hydrophobia tae saliva contained con-tained the deadly germs of rabies When a person has been bitten by a dog the sore should not be cauterized The cautery sometimes makes bad wounds which are difficult to heal and it produces inflammations The wound should be washed out freely with plenty of water and treated with antiseptic dressing It is a blunder to kill the dog such a course is revengeful and brutal Some people I have treated only because they have killed the dQg When perhaps it was not really mad The doubt however remains and in such I cases makes treatment imperative The popular fallacy which leads to the slaughter slaugh-ter of the dog is duo to superstition and most people still believe that with the death of the animal the venom dies also I can not qualify such foolishness A few da s of waiting would have shown whether or not the Tog was really madthe wound being dressed meanwhile as T have sug pested and if after being watched the dog showed signs of hydrophobia then the treatment could be had without further delay de-lay It is only a trifling burden for fifteen days when it is all over As an illustration of the scepticism this institute has had to encounter I mightmen i i tion one case in point Judge Mattcrson of Texas was bitten and by the advice of some friends com east for treatment lore he met other friends some of them in the profession who gravely urged him togo to-go to Pa4teur at once Still in doubt he cabled l to Paris and the reply he received froth Pasteur was Go and be treated by Gibier When this institute was established a few months ago I knew not whether it would be successful or otherwise but the system has met with encouragement beyond be-yond all expectation There are some peo pIe who have uged me to make a business of the institute some who want to make it a hospital to receive patients and board them and charge stated prices but I will not make it a business There is another view however and it refers to the philan thropic aspect of the question There would be no objection raised to the estab ft 3ATi I Lp i M aai IK THE L1 ORATORY lishment of an institution ona scale and plan that would contemplate a purely philanthropic phil-anthropic basis of operations giving this country the same benefits that the people of France derive from the institute in that country To such an enterprise I would gladly contribute the benefit of my experience experi-ence and would aid in every possible way in counsel and direction to secure its permanency I per-manency and success With regard to the system itself it is worthy of remark that among the physicians physi-cians of the very highest standing the proportion pro-portion of those who are against is diminishing dimin-ishing every day Among those who remain re-main in the opposed school although they are many of them learned and distinguished disting-uished men there is no one who is an experimentalist ex-perimentalist The leaders among the opponents op-ponents of the system are for the most part distinguished merely as theoricians or clinicians and not experimentalists in pathology But among the higher men of the profession who work experimentally and dont make medicine as some men make religion and who will not believe where they dont see there is no one who is opposed to the method It is gaining ground steadily among the progressive men j in the profession The few who are still I j opposed to it are to be found among the reactionaires or conservatives They recall re-call the saying of Hippocrates concerning his critics that they held that a thing could not be so because they did not think it could be so They invariably have perfect confidence in their own judgment and believe be-lieve it cannot be wrong by any possibility On the other hand the experimentalists too have perfect confidence because they have tried and investigated for themselves It is my fortune to meet the most progressive pro-gressive men among the profession in this country and ail take the liveliest interest in the system The State Medical societies socie-ties in this state and in New Jersey have given it a cheerful welcome These are the I practical menthe workers of the profession profes-sion some of them men of thehighest distinction I dis-tinction PAUL GiniEH M D |
